About LRA

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Major Projects

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LRA has gained national recognition for our courses on incident management and conducting investigations. Since 1984, LRA has had many opportunities to work with clients in developing creative and cost effective ways to deliver training programs and other consulting interventions. In addition to the approximately 100 investigative and incident management training programs that LRA conducts each year, the following is a list of just some examples of LRA projects and experience:

Paul with student

1. Developed a process for evaluating the quality of investigations including a set of standards and methodology that allows investigators and the agencies in which they work to measure the quality of their work. We have assisted agencies in developing and implementing a self-assessment or quality improvement process for investigations at the following agencies:

  • The Texas Department of Protective and Regulatory Services (Adult Protective Services) (1996).
  • State agencies serving persons with mental retardation/developmental disabilities in Tennessee (1996), Pennsylvania (2001), New Jersey (2003), District of Columbia (2006), Iowa Department of Human Services (2006), and New Mexico (1992) who provide services to persons with developmental disabilities/mental retardation.
  • Departments of mental health and mental retardation in Illinois (Equip for Equality, 1993), Alabama (2002), and Kentucky (1995).
  • National private providers of services to the persons with developmental disabilities (Res-Care in 1997 and Mosaic in 2010).

2. Provided ongoing external evaluations of the quality of investigations in Kentucky, Pennsylvania, Iowa, and Tennessee.

3. Developed a certified investigators program that has been implemented in both private and public agencies including oversight agencies. This program has been implemented state-wide in agencies providing developmental disabilities and/or mental health services in Tennessee (2000), Pennsylvania (2001), Alabama (2003), New Jersey (2003), Kentucky (2005), Iowa (2006), and District of Columbia (2007). Several private providers of DD services require that any potential investigator successfully completes training and passes an exam before they are permitted to conduct investigations. The training and examination are supplemented with an on-going process for evaluating the quality of investigations certified investigators subsequently conduct.

4. Developed an investigations training program for state survey agencies based on the three primary methods used during the survey process to organize an investigation and promote a systematic collection of facts on which conclusions are based. This course was developed in conjunction with the Texas Department of Aging and Disability Services (Regulatory Services) in 2012 and tailored for use in all state survey agencies.

5. Developed an expanded four-day certified investigators training program in Pennsylvania (Office of Developmental Programs) required for all investigators in both public and private providers. As of December 2008, 167 sessions of this course have been delivered by LRA with the certification of more than 4,000 individuals. In addition to developing and delivering the training portions of the program, LRA assumed a large part of the administrative responsibilities for registering and scheduling students, keeping examination records and notifying students of examination results. LRA has performed these tasks from its office in Austin, TX.

6. Developed an internal examination process for certifying investigators that is maintained in-house for Devereux, the Alabama Department of Mental Health and Mental Retardation, the New Jersey Division of Developmental Disabilities and the Tennessee Division of Mental Retardation Services.

7. Developed and provided incident management training programs designed for both management and direct care staff.

8. Worked with Iowa (2006), District of Columbia (2006), New Jersey (2003), Alabama (2002), Pennsylvania (2001), Kentucky (2000), Tennessee (1995), and Louisiana (1990) in developing state-wide incident management policies and procedures.

9. Developed multi-media CDs to supplement training on the investigation of incidents and evaluating the quality of investigations.

10. Developed and provided a training curriculum, Protecting People from Harm, designed to promote understanding among direct care staff regarding the circumstances likely to result in serious incidents, identifying strategies to respond to those circumstances and ways in which management and supervisory staff can support their efforts.

11. Delivered a train-the-trainers program for our Conducting Serious Incident Investigations course for several clients. They are now able to provide our curriculum on an on-going basis to meet demand for additional investigators, and as refresher training for those already trained. We have delivered the train-the-trainers program to state agencies in Iowa, Louisiana, Tennessee, Missouri, Alabama, New Jersey, Iowa and New Mexico as well as Mosaic and Devereux, private providers of developmental disabilities services.

12. Provided ongoing support to investigators in Pennsylvania with a web-based Investigators' Help Desk, which offered investigators a wide range of additional supports including: on-line access to manuals and policies; an opportunity to ask questions on-line and view written answers to other investigators' questions; and, additional training materials, including links to articles and WEB sites related to investigations.

13. Conducted the following studies in conjunction with Equip for Equality (EFE), the protection and advocacy agency for Illinois.

  • Reviewed 130 investigations as part of base-line and follow-up studies of the quality of investigations conducted by Office of the Inspector General investigators in 4 Chicago area facilities (1996). A report was issue for each phase of the study (Not Our Problem: Executive and Legislative Response to Violence in State Operated Institutions in Illinois).
  • Assessed the implementation of state policy regarding restraint and seclusion use in state mental health and mental retardation facilities in Illinois
  • Assessed 61 children and adults who died while in restraints in the National Review of Restraint Related Deaths, a project funded by Congress (2009). Lana Norwood, President of LRA, was hired to coordinate the development of the review methodology, aggregate and analyze the data and compile a written report of the findings of the analyses. The review process was designed to facilitate an accurate and reliable analysis of the relationship between the restraint and the individual’s death; the degree to which application of the intervention met relevant federal regulations, Joint Commission on Healthcare Organizations (JACHO) standards, and best practices; and the specific risks associated with the use of restraints in each case.

The following is a list of LRA training manuals and other training technology related to conducting investigations and incident management and offered in conjunction with our training:

  • Conducting Serious Incident Investigations, An Instructor’s Manual
  • Conducting State Survey Investigations: Techniques for Observation, Interviewing and Record Review
  • Advanced Course in Investigations, workbook and curriculum
  • Weighing Evidence and Drawing Conclusions, workbook and curriculum
  • Writing Investigative Reports Course, workbook and curriculum
  • Interviewing Persons with Disabilities Course, workbook and curriculum
  • Refresher Course in Investigations, workbook and curriculum
  • Introduction to Investigations, workbook and curriculum
  • Understanding Serious Incident Investigations, A Training Program for Direct Care Staff, workbook and curriculum
  • The Role of the Supervisor in Conducting Serious Incident Investigations, Participants’ and Instructors’ Manuals
  • Incident Management: Creating Effective Incident Management Policies and Procedures, manual, workbook and curriculum
  • Mortality Review and Death Investigations, manual, workbook and curriculum
  • Facilitating Root Cause Analysis, Workbook, manual and curriculum
  • Protecting People from Harm, A Manual for Direct Care Staff on the Principles of Incident Management
  • Conducting Investigations [multi-media CD to be tailored by site]
  • Evaluating Investigations [multi-media CD to be tailored by site]
  • Conducting Serious Incident Investigations, A Manual for Investigators